South Africa’s NHI pilot projects were not a failure: health minister

 ·17 Sep 2019

South Africa’s new National Health Insurance (NHI) will be successful and the pilot projects which tested the proposed system across a number of districts were not ‘failures’.

This is according to the minister of health, Zweli Mkhize, who was responding in a recent parliamentary Q&A session.

“The pilot projects were not NHI pilots but health system strengthening projects implemented in the NHI pilot districts intended to improve the public health system,” Mkhize said.

“The independent assessment of the health system strengthening projects does not describe the projects as a failure. In fact, the independent evaluation recommended that all the projects should continue with some amendments in some cases.”

Mkhize added that the NHI policy was finalised after widespread research and consultation with local and international experts prior to its finalisation.

“We, therefore, believe that the NHI will certainly be successful,” he said.

“We have had the benefit of the experience of several countries before us that have had positive and negative lessons relating to their universal health coverage implementation experiences.”

Pilot projects 

The pilot projects were first detailed in the Public Health Strengthening Report on the NHI released in July.

The evaluation report was the collaborative effort of a consortium led by Genesis Analytics (Genesis), with support from PriceWaterhouseCoopers Advisory (PwC), the Centre for Health Policy (CHP) at the University of Witwatersrand and Insight Actuaries and Consultants (Insight) at 10 pilot projects across the country.

The report in its findings and discussion notes that overall, the implementation of the pilot intervention had ‘mixed success’ across the pilot district.

“None of the interventions can be considered ‘failures’, as all were implemented at scale. However, as with the implementation of any programme, there are important lessons to be learned, which can strengthen these programmes in the future,” the report noted.

Where successful, the panel identified a few common factors. Among these are strong political will, adequate human and financial resources for implementation, good coordination and communication, and good monitoring systems put in place at the time of implementation.

The interventions, to a great degree, hindered success. These included inadequate planning, lack of resources, inconsistent communication, a lack of coordination where necessary and insufficient mechanisms to monitor progress to ensure course correction.

Read: Your new life under South Africa’s NHI

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